The damaging effects of secondhand smoke have been known for years, and were detailed in a similar surgeon general's report in 1986. But newer findings now implicate ambient smoke in homes and public places in increasing the risk of asthmaasthma attacks, sudden infant death syndrome (SIDS), and blood vessel damage -- sometimes even after relatively brief exposures.

The report also notes that that indoor smoking sections and even ventilation have been shown to be ineffective in keeping nonsmokers from exposure.

State and Local Bans

Fourteen states and hundreds of local governments have banned smoking in public places -- including restaurants and bars -- as a way to minimize secondhand smoke exposure.

Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, says the report leaves "no doubt" that states and local governments should act immediately to ban smoking in public areas.

"It can't be left up to voluntary action," he tells WebMD.

Carmona urged states to push forward with rules guaranteeing smoke-free environments. "Anything less cannot ensure that nonsmokers are protected," he says. But when asked what role the federal government should take in minimizing exposure to a known carcinogen, Carmona said those decisions are up to Congress.

Many major cities, including New York City and Washington, have banned smoking in bars and restaurants. In Washington, the move was billed as a way to lower secondhand smoke exposure for patrons, and especially for workers.

Owners and their trade groups have actively opposed the ordinances, citing worries that new laws would chase smoking clientele from bars and restaurants.